By Eileen Hansen, MSSW & Sandra Sundeen, MS
[Winter 2006; Vol. 33, No. 1; Pg 10]
The
Mental Health Services Improvement Collaborative(MHSIC) at the University of
Maryland School of Medicine is housed within its Department of Psychiatry and
Human Behavior. It is administratively part of the Division of Services
Research(directed by Lisa Dixon, MD) and is overseen by Howard Goldman,
MD, PhD. It is an academic-public partnership with the Mental Hygiene
Administration(MHA) that is divided into three centers. One of its
components, the Mental Health Services Training Center, has operated since 1991.
The Collaborative was established in 2001, when the two other components–-the
Evidence-Based Practice Center(EBPC) and the Systems Evaluation Center(SEC)--
were created.
The
Training Center provides a wide array of teaching for professionals who provide
services. Some of these activities take place at the annual MHA
conference.
The
Evidence-Based Practice Center trains professionals and assists them in
delivering evidence-based practices, including Supported Employment, Family
Psychoeducation, and Assertive Community Treatment. It currently uses
federal funds granted to the Mental Hygiene Administration to teach
techniques designed to reduce the use of seclusion and restraint.
The
Systems Evaluation Center has done numerous evaluations for the MHA, including
designing a statewide Outcomes Management System and developing a survey tool to
measure how patients perceive the cultural competence of the professionals who
treat them.
An
example of the delivery of a major initiative in Supported Employment can
illustrate the functions of each of the centers and the Collaborative as a
whole. This initiative developed as part of two national projects in
evidence-based practices. The MHA agreed to implement Supported Employment
in three sites as part of the national EBP project co-sponsored by SAMHSA and
the Robert Wood Johnson Foundation and to add three more sites as a part of
another initiative funded by the Johnson & Johnson family of companies.
The
Collaborative then began working with the above initiative through its Training
Center. Using the MHA Annual Conference in 2001 as a kickoff, it sponsored
training by Robert E. Drake, MD, PhD and other evidence-based experts. Supported
Employment Consultant/Trainers at the six sites taught organizational change and
consensus-building, and provided on-site consultation. The Systems
Evaluation Center’s role was to monitor the progress of the implementation in
each of the six sites. Additionally, the SEC Implementation Monitor and
the Evidence-Based Practice Center (EBPC) Consultant/Trainer together conducted
monitoring activities every six months, designed to measure if the EBP model was
being followed. This information was then shared in a report to the sites
by the EBP Trainer/Consultants so that ongoing technical assistance could be
provided; it then served as the basis for ongoing technical assistance.
As
implementation and monitoring continue to be performed by the EBPC and the SEC,
the Training Center sponsors additional teaching activities to promote the
adoption of evidence-based practices throughout the state. In this way,
the three MHSIC centers address practice improvement initiatives independently,
but collaboratively.
Dr.
L: That was one of those interesting events in my life. Writing about them has
been a way of processing them. Not only tragedies like the deaths of my sons,
but other things like learning of my adoption as an adult and my search for my
birthmother. These are life-altering experiences and writing about something is
a good way to figure out what to make of it.
Patients,
of course, are an endless source of inspiration and stories. Psychiatry is a
performance art. We talk with people; they tell us their secrets and their pain.
They benefit from the conversations or not. But it’s all words in the air; our
case notes are sealed and unless we write something down, the experiences are
lost except to our memories. But we’re changed by these stories just as our
patients are and the truths they lead us to are worth preserving. Writing down
what we have learned also constitutes a kind of “ethical will,” something to
convey to succeeding generations in the same way that we distribute our
property. I think that we have some obligation before we die to enunciate
whatever we think we’ve learned about life. So that was also a motivation to
write these books, because I thought that whether anybody buys them or not, my
children and their children will have this gift from me.